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Identifying Shiny White Streaks in Melanoma

J Am Acad Dermatol; 2018 May; Verzi, et al

Polarized dermoscopy is a valuable diagnostic tool in the identification of shiny white streaks (SWSs), a feature that is highly specific for melanoma, a recent study found. Polarized dermoscopic images of histopathologically diagnosed melanocytic neoplasms were analyzed for presence and pattern of SWSs. Histology was also reviewed for correlation. Researchers found;

  • Among 1,507 melanocytic neoplasms, SWSs were observed in 31 of 144 melanomas (22%) and 22 of 1,363 benign neoplasms (1.6%).
  • The sensitivity and specificity of SWSs for melanoma were 22% and 98%, respectively.
  • Diffuse SWSs exhibited the greatest diagnostic value for melanoma, with sensitivity of 11.8% and specificity of 99.5%.
  • Focal central and peripheral SWSs were comparable in diagnostic significance.
  • The presence of SWSs was highly uncommon in dysplastic nevi, whereas in certain benign subgroups of nevi such as Spitz nevi and atypical genital special site nevi, SWSs were not uncommon.

Verzi AE, Quan VL, Walton KE, et al. The diagnostic value and histologic correlate of distinct patterns of shiny white streaks for the diagnosis of melanoma: A retrospective, case-control study. J Am Acad Dermatol. 2018;78(5):913-919. doi:10.1016/j.jaad.2017.11.021.